![]() ![]() ![]() The annual number of patients visiting the two emergency centers is approximately 100,000. The population of the study area is 849,992 and covers an area of 1,175.31 km 2. We obtained medical records of two regional Emergency Medical Centers from 1 January 2016 to 31 December 2017. In this pilot study, we aim to determine whether the application of double defibrillation improves the rate of survival to hospital discharge, survival to hospital admission, and neurological outcome at 12 months in refractory VF/pVT patients. It is easy to apply and can be used in the prehospital stage. Double defibrillation is a method where two sets of defibrillator pads are applied and two “simultaneous” or “sequential” shocks are delivered. Double defibrillation has been recommended to increase survival rates for such patients. In one study, beta-adrenergic antagonists were recommended for refractory ventricular fibrillation (RVF) patients. Recent studies exhibit diverse results regarding the treatment of patients with refractory shockable rhythms. Patients with refractory shockable rhythm show a survival rate of 8.2%. Patients with shockable rhythm at the prehospital stage have a survival rate of 21.4–29.3%. The 2015 American Heart Association (AHA) and the European Resuscitation Council (ERC) guidelines recommend defibrillating and administering amiodarone for refractory shockable rhythms. However, optimal treatment for refractory shockable rhythms remains unclear. Current guidelines recommend rapid defibrillation for cardiac rhythms that require defibrillation. Cardiac rhythms that require defibrillation (ventricular fibrillation/pulseless ventricular tachycardia, VF/pVT) show higher rates of survival than those that do not. Survival rates for prehospital cardiac arrest are affected by factors such as bystander cardiopulmonaryresuscitation (CPR), witness of arrest, initial cardiac rhythm, and bystander CPR before emergency medical system (EMS) arrival. ![]() However, DSiD did not improve neurological outcome at 12 months. In patients with refractory shockable rhythms, DSiD has increased survival to hospital admission and a trend of increased survival to hospital discharge. Good neurological outcome at 12 months of the DSiD group was higher than that of the conventional defibrillation group, but the difference was not statistically significant (5/17 (29.4%) vs 2/21 (9.5%), ). 6/21 (28.6%), ) and showed a trend for higher survival to discharge (7/17 (41.2%) vs. The DSiD group had a higher survival to admission rate (14/17 (82.4%) vs. Twenty-one patients underwent conventional defibrillation, and 17 underwent DSiD. Data were regarded statistically significant when. Statistical analysis was conducted using Fisher’s exact test. Secondary outcomes included survival to hospital admission and good neurological outcome at 12 months. Primary outcome was survival to hospital discharge. During the prephase, we conducted conventional defibrillation with one defibrillator, and during the post-phase, we conducted DSiD using two defibrillators. The post-phase was from January to December 2017. The prephase was from January to December 2016. ![]() This is a retrospective pilot study performed using medical records from 1 January 2016 to 31 December 2017. We conducted research on the application of double simultaneous defibrillation (DSiD) for refractory shockable rhythms. Treatments for refractory shockable rhythm presenting after defibrillation and medical treatment are not definite. Refractory shockable rhythm has a high mortality rate and poor neurological outcome. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |